Client Eligibility

SERVING THE FOLLOWING COUNTIES:

Stafford, Spotsylvania, King George, Orange, Westmoreland, Caroline, and the city of Fredericksburg.

EFFECTIVE IMMEDIATELY- (as of September 17, 2015)

Due to changes in the intake information required by the state, FCS clinic now must complete a formal financial intake on all new clients and all currently active clients.

If you are a current client, you can make an appointment to complete this information either before or after your next appointment. Or you can gather the documentation and bring that to one of your next appointments. All charts should be updated by the end of October, 2015.

If you are a new client,the financial form must be completed before your counseling can start.

Information the client must provide includes:

Picture ID

Proof of Residency (utility bill, driver’s license, something current that shows your name and address)

Most recent Federal Tax Return (1040 or 1040EZ- if you don’t have a copy you can call 1-800-829-1040 for one)

W-2 form from most recent calendar year

Pay Check Stubs (if working, for one month, must be recent)

Social Security, Disability check, or Award letter (current year if applicable)

Unemployment compensation check or award letter (if applicable)

Or other identifiers

If you have questions, please call Anise (Program Manager) and she will be happy to clarify the information for you. Where we are funded in part by the state, FCS Clinic must follow their rules or risk losing that funding.

Thank you for your patience and understanding about this change.

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